This article and comments were prepared before Netflix recently pulled a controversial documentary about root canals called Root Cause. For those of you that have seen it or heard about it and have questions about your own root canals, I wanted to address these questions in this article. As always, you may contact me if you have further questions.
If you do have root canals, you don't need to worry about them. However, if you do have concerns, we have x-rays and sophisticated 3D scanning equipment to assess and reassure that your root canals are stable and healthy. Regular dental checkups are a good habit, regardless of whether you have root canals or not.
Regular dental checkups allow us to keep an eye out for any problems with any of your teeth and dental health. We can also check for periodontal disease, which HAS been scientifically shown to have links to other systemic diseases. We are very proud of our hygiene program and have developed exceptional techniques to keep your periodontia healthy and for you to enjoy a high-quality healthy life.
Interestingly, between our two offices, we have at least ten long-standing patients well into their 90's, who have root canals and dental implants, and all are doing well and enjoying life. Quality dental care, no matter how old you are, is of great benefit to your oral health.
Root Cause: Dangerous Misinformation
The NetFlix documentary called Root Cause was at one time one of the top trending documentaries on Netflix and has been making some waves in the dental and oral health community. Both frontline healthcare professionals, such as dentists and oral surgeons as well as oral health scientists and researchers have roundly condemned the film’s central claim that root canals are the cause of many chronic diseases. The common thread of criticism points to the film’s claims as a complete fabrication and unbacked by actual science.
Many professional associations, academic institutions, and scientific organizations have all requested that Netflix remove the film due to it’s unsubstantiated and misleading claims. While “Root Cause” is zealous in presenting theories and non-factual claims, many doctors are concerned that the "so-called" documentary may become a public health concern if it dissuades people from seeking necessary dental treatment. Those who suspend a necessary root canal may face much more severe health consequences that could even be life-threatening.
The American Association of Endodontists (AAE), American Dental Association (ADA), and the American Association of Dental Research (AADR) all requested Netflix remove the film because it’s disingenuous, deceptive, and distorted proof. The fact that Netflix pulled the offending piece of content from their library suggests that even the media streaming giant Netflix, which has no problem platforming various other pseudo-scientific documentaries, found “Root Cause” to be problematic and confounding.
What is Root Cause?
Root Cause is a story of a man’s journey in identifying the source of his physical pain and suffering. According to the main protagonist, the source cause of his misery is a root canal he underwent as a younger man. The film, under the guise of a documentary, then goes on to attempt to prove it’s assertions that root canals are dangerous and are the "root cause" of a plethora of chronic illnesses. The film also makes an attempt to feature doctors and dentists from around the world who practice holistic medicine to validate their opinion.
What The Critics Are Saying
Nearly every major dental health and oral health organization has denounced the film for disseminating deceptive and inaccurate if not utterly false information.
The AAE, ADA, and AADR have called the film's central claims “baseless” and gone on to question the film stating “Why portray information demonstrated to be incorrect as fact?”
The UCLA School of Dentistry goes on to say that the film’s “premise is based on junk science and faulty testing conducted more than 100 years ago that was debunked in the 1950s.”
The Science Behind Root Canals
The critics are right. The science isn’t there. The central thrust of the documentary is built on research conducted a century ago in the 1920s. Focal infection theory, which has deep historical roots and gained prominence in the 1920s, informs much of the film’s stance on medicine.
If the premise of your thesis is built on data conducted in primitive laboratories and without proper controls, there’s probably something wrong. If that is not enough of a red flag, much of the research the film is based on, also known as focal infection theory, was rigorously disproven or shown to be inaccurate in the 1950s.
The fact is the theory was wrong. Patients with chronic diseases presumably caused by a focal infection did not improve when those infections were removed or eliminated. While it may seem silly today, before the 1950s and based on faulty research done in the 1920s, there was a real belief that everything from heart disease to chronic arthritis could be the result of an infected tooth. Not only does the film ignore the fact that its scientific basis had been already debunked over 70 years ago, but it also goes on to make a host of other jaw-dropping inaccurate claims.
The 5 Most Outrageous Claims Made in "Root Cause"
This eye-popping claim is dangerously misleading. According to the so-called documentary, “Ninety-eight percent of women that have breast cancer have a root canal tooth on the same side as their offending breast cancer.”
The most noticeable problem with this statement is its reliance on the logic of meridian systems, which are not based in modern medical science. Cancer researchers maintain that there is no link between root canal procedures and any cancer. A 2013 study published in a journal associated with the American Medical Association (JAMA) found that root canals did not affect a patient’s risk of developing cancer of any type. Furthermore, the researchers were surprised to learn that patients with more than one endodontic treatment, or a root canal, had a 45 percent less chance of getting cancer.
The claim that 9 out of 10 of all health issues arise from the mouth is absurd on its face. However, it does expose the film's reliance on debunked focal infection theory which states that systemic diseases are caused by local infections somewhere else. Unfortunately, the idea that everything wrong with your body is caused by bacteria somewhere else doesn’t make sense. Most doctors would not claim, for example, that a chronic fungal infection on your foot is the result of something happening in your mouth. Likewise, most doctors would not argue that the infected tooth of a lifelong smoker was the cause of his lung cancer. Most people don’t need to go to medical school at all to be able to reflect on their lives and realize that there are better explanations for chronic health issues than a root canal procedure.
This is just an outright falsehood. The number one cause of heart attacks is coronary heart disease. The factors that exacerbate coronary heart disease, and thus lead to heart attacks, are well known and well researched. The most important include smoking, diabetes, alcohol abuse, obesity, and high levels of HDL cholesterol indicative of an unhealthy diet.
While there is a link between periodontal disease and heart disease, the two diseases are viewed as confounders. One does not necessarily cause the other — Furthermore, research points towards root canal therapies as a way to reduce the risk of heart attacks. According to a 2017 study, patients with root canals that had been filled displayed a lower risk of cardiovascular problems, not more. That’s likely because root canals remove infected tissues thereby eliminating a source of chronic irritation, inflammation, physiological stress, and an elevated immune response.
The documentary belies a complete misunderstanding of the role, both positive and negative, that various microorganisms, including bacteria, play in our lives. The truth is, bacteria are important and healthy for our body. The vast majority of the microbial organisms that call our bodies home are not only harmless but actively aid us in everything from digestion to fighting off “bad” disease-causing microbes. The film’s claims that all root canals are infected with bacteria is a mischaracterization of bacteria that betrays an ignorance of basic biology.
It is true that a root canal can never indeed be 100 percent sterilized. No part of the body can be. However, the reason root canals are necessary is to remove necrotic tissues rife with endotoxins released from dead bacteria. It’s not the bacteria themselves that cause harm; it is the endotoxins they produce as waste and also release upon dying that cause necrosis. Root canals remove and eliminate that necrosis. Furthermore, the only alternative to a root canal treatment is a dental extraction followed by replacement of an artificial dental implant. This more than likely is not the best recourse.
The very concept of meridian lines is not grounded in modern science. The meridian system itself is based entirely on Chinese folk medicine. According to Chinese beliefs, the meridian lines are conduits for the flow of “life energy,” or “Qi.” While the concept of “life energy” and meridian lines are central to Chinese folk medicine, they bear no relevance to modern medicine.
Where's the tiny kernel of truth?
From the perspective of a dental professional, it can be easy to laugh off the many ridiculous and sometimes absurd claims made in the film. However, like the anti-vaccine and anti-fluoridation movements that have taken hold in many communities, lousy information tends to have a long shelf life. Even when their central claims have been debunked time and time again with indisputable facts and reasons, these conspiracy theories tend to stick around for a long time. Just look at moon landing skeptics, flat earth theorists, and a multitude of other tinfoil hat movements that haven't merely survived over the decades, but thrived and flourished.
That’s because many of these outrageous myths are often built on a tiny, sometimes not even relevant, kernel of half-truth.
In Root Cause, it’s clear that the filmmaker has a personal preference for holistic medicine over conventional medicine. Many holistic treatments view the human body as an interconnected whole. This isn’t necessarily wrong. Scientists do know that oral health is connected with overall health. Bacteria responsible for endocarditis of the heart valve, for example, can also be found in the mouths of patients with gingivitis or periodontitis. It is undoubtedly true that when your mouth is unhealthy, it can affect your overall health. However, to pin the blame for “70-90 percent of medical illnesses” onto a ho-hum, standard dental procedure such as a root canal surgery is a leap of logic that defies common sense.
Fighting Fear With Fear: What Happens If you Don't Get A Root Canal When You Need One?
In the age of viral movements built on completely unsubstantiated pieces of information, it’s clear that Root Cause is just another in a litany of pseudo-scientific works of media designed to play off of people’s natural fears. Getting a root canal is scary for many people. Root Cause merely gives these people another reason to avoid getting the dental and oral health care they need.
A patient who may be suffering from advanced dental decay would benefit significantly from a root canal procedure. However, as a result of the fear and misinformation spread by sensationalist works of media, including Root Cause, that patient may avoid treatment until it’s too late.
Here’s what can happen if you skip a root canal.
You will lose your tooth.
The infection may spread into your periodontium and damage your jaw bones.
The infection may become life-threatening if it enters the bloodstream.
Resulting tooth loss may result in dental shifting, malocclusion, and bone resorption.
You may experience immense dental pain.
You may experience severe dental sensitivity.
The consequences of ignoring an infected tooth and avoiding a much-needed root canal are quite severe. Severe tooth decay is an infection of the inner tooth and can only be treated by removing the necrotic tissues and sealing the resulting cavity to prevent food debris and bacteria from reentering causing further problems.
Contrary to the claims made in Root Cause, the tooth itself is not dead following a root canal. Periodontal ligaments and other very much living tissues remain in place.
My opinion, Root Cause is merely propaganda, junk science at best.
"Root Cause is merely propoganda, junk science at best."
--- DR. MAMALY RESHAD, DDS
DR. MAMALY RESHAD
Advanced Prosthodontics - USC
Chairman - Fixed Prosthodontics and Operative Dentistry